Name of the Procedure:

Ankle Foot Orthosis, Fracture Orthosis, Tibial Fracture Orthosis, Semi-Rigid, Prefabricated
Common Names: Ankle Foot Orthosis (AFO), Fracture Brace, Prefabricated AFO

Summary

This procedure involves fitting and adjusting a semi-rigid, prefabricated orthosis to support and immobilize the ankle and foot, particularly for patients with tibial fractures. The orthosis helps stabilize the foot and lower leg, promoting healing and improving mobility.

Purpose

This orthosis is primarily used for treating and managing tibial fractures. The goal is to immobilize the affected area, reduce pain, and facilitate proper bone healing while allowing some degree of mobility.

Indications

• Tibial fractures
• Post-operative support for lower limb surgeries
• Severe ankle or foot injuries
• Conditions requiring stabilization of the ankle and foot

Patients suitable for this procedure typically:

• Have sustained fractures that benefit from semi-rigid support
• Require stabilization to prevent further injury during the healing process

Preparation

• No specific fasting or medication adjustments are generally required.
• A thorough physical examination and imaging tests (e.g., X-rays) are needed to determine the extent of the fracture and the appropriate orthotic support.

Procedure Description

1. Assessment: The healthcare provider assesses the injury and selects the correct size and type of orthosis.
2. Fitting: The prefabricated orthosis is adjusted to fit the patient’s ankle and foot comfortably while ensuring proper immobilization.
3. Adjustment: Straps and fasteners are carefully adjusted to ensure a snug fit that doesn't restrict blood flow.
4. Instruction: The patient is instructed on how to wear and remove the orthosis, as well as how to care for it.

Tools and Equipment

• Semi-rigid prefabricated orthosis
• Straps and fasteners
• Padding for comfort

Anesthesia or Sedation

No anesthesia or sedation is required for fitting the orthosis.

Duration

• The fitting and adjustment procedure typically takes about 30 minutes to an hour.

Setting

• The procedure is usually performed in an outpatient clinic or an orthopedic office.

Personnel

• Orthopedic specialist or physician
• Orthotist (a healthcare professional who designs and fits orthoses)
• Nursing staff for support and instruction

Risks and Complications

• Common Risks: Skin irritation or pressure sores from the orthosis.
• Rare Risks: Improper fit leading to inadequate support or further injury.
• Management: Regular follow-up and adjustment of the orthosis, pain management, and skin care instructions to mitigate risks.

Benefits

• Improved stabilization and support for the injured foot and ankle.
• Reduced pain and enhanced healing of the fracture.
• Potential for more comfortable and earlier mobility compared to traditional casting.

Recovery

• Patients should follow care instructions, including regular cleaning of the orthosis and monitoring for any signs of skin irritation.
• The expected recovery time varies based on the severity of the fracture but typically ranges from several weeks to a few months.
• Regular follow-up appointments will ensure the orthosis continues to fit properly and the fracture is healing as expected.

Alternatives

• Plaster Cast: Provides complete immobilization but is less comfortable and restricts mobility.
• Custom Orthoses: More expensive and may require more time to fabricate.
• Surgical Options: In severe cases, internal fixation may be required but involves more risks and longer recovery.

Patient Experience

• Patients may initially experience discomfort while getting used to the orthosis.
• Proper fit and padding can enhance comfort.
• Pain management strategies, such as over-the-counter pain medications, may be recommended.
• Instructions on walking with the orthosis to ensure safety and prevent complications will be provided.